How to keep training when injury stops you running

Injury is heartbreaking for runners, but the right rehab can get you back on your feet. Photo: iStock

As a runner there’s probably nothing more frustrating than when you can’t run. Over the course of my amateur running career, there have been several times when injury has kept me from doing what I love most.
The worst time was when I got within three weeks of the start line for my first marathon and gave myself a stress-fractured fibula from overtraining. Besides being incredibly painful, the injury meant I couldn’t run for six weeks. After the shock of the initial diagnosis, denial set in, followed by frustration and even despair.
Since then, I’ve had to deal with several more running setbacks and each time I’ve handled it better, thanks to a great team of physios and massage therapists. Now when I get injured, I don’t throw the baby out with the bath water. Instead I look for ways that I can ‘run’ even if I can’t actually run.

Mark Green is a physiotherapist, running technique expert and one of Australia’s top off-road ultramarathoners.

Physiotherapist Mark Green from Sydney’s The Body Mechanic knows from experience how hard it is to stop running because of injury. He has been competitively running for 32 years and working in sports clinics for 18 years. During this time, he’s had seven ankle fractures; two ankle operations; a knee arthroscopy and a ruptured calf muscle – just to name a few.
“My experience of having sustained these injuries drives me to develop practical and reliable treatment and rehabilitation plans that help clients return to running,” Green says.
“While some medical practitioners will tell runners to stop training, I try to do everything possible to help them get to the start line, because if they get there then they’ll cross the finish line.”

Depending on the injury, stairs are a great way to build strength and rehabilitate your body. Photo: Michele Mossop

He says that depending on the injury, there are activities runners can do to mimic running, strengthen the relevant muscles, and help to speed up their recovery.

1. Pool running

Also known as aqua jogging, it is one of the most effective cross-training methods for runners sidelined by injury. Green says this low-impact yet high-resistance exercise is an excellent way to engage the same group of muscles used when running. “It’s harder to keep the same posture or maintain the same cadence (steps per minute) when pool running, but because it closely mimics the movement pattern of running, it provides a great cardio workout and helps maintain most of your running-specific muscles.”

2. AlterG anti-gravity treadmill

This space-like treadmill has revolutionised medical rehabilitation in recent years. Its unweighting technology allows injured athletes to start running again through reducing gravity’s impact by selecting any weight between 20 to 100 per cent of your body weight by one per cent increments. Green says, “the AlterG is the next best thing to running, without putting more stress on injured muscles or bones”. A session on the AlterG isn’t cheap though, with the average price being $1 per minute.

3. Stair walking

Depending on the injury, a great way to build strength and rehabilitate your body back from injury and into running again is stair walking. The plyometric motion strengthens the same muscles as lunges and squats, helps to improve balance, and taxes your lungs and heart as you power to the top.

4. Walk and run

If you’re used to going for runs that last longer than 30 minutes, but are too injured to do this, then a good alternative is to lightly jog for five minutes and walk for 20 minutes, then repeat. Green says this program will gently ease you back into running, while still getting the mental satisfaction of getting outdoors and making progress with your recovery.

5. Replace one love with another

It might be hard to love two things equally, but try replacing running with another sport you enjoy such as swimming or cycling. “The reason people run is usually because they get more of a high from running than they do from any other form of exercise,” says Green. “If runners are injured then they should replace running with something that is just as enjoyable, yet still gives them a decent workout, so that it’s sustainable.”

6. Avoid High Intensity Interval Training (HIIT)

If you’re returning from injury avoid high intensity interval training unless it’s all non-impact exercise such as boxing. “There are plenty of activities you can do to get your heart rate up, but the high-impact jumping, landing and sprinting that is a feature of HIIT is the worst thing you can do,” warns Green.

7. Monitor the pain

When returning to running following injury, the best guideline to keep you from going backwards in your recovery is pain. Green says that returning to running following an injury doesn’t need to be completely pain-free, but it shouldn’t make an injury feel worse or create any new niggles. “The last thing you want to do is stir up the pain by overtraining too early. When you start back running, closely monitor the pain level and if it’s slight and doesn’t get worse the day after, then gradually increase your training – but take it slow,” Green says.

8. Stop injuries before they happen

If you’ve been injured it’s worthwhile seeing a physiotherapist, podiatrist or running technique coach to help get to the bottom of why you got injured in the first place. Choose a healthcare practitioner who is actually a runner, as they will have a much better understanding of the loads and stresses involved. “The single biggest factor that causes injuries in runners is doing too much too soon. The second factor is the way people run, so if you can improve the way you run you’re less likely to get injured,” Green says.
He says having a biomechanical assessment to see how the body moves when you run can be a real eye-opener for runners. “A screening helps to anticipate any potential problem areas in the body, and gives runners practical advice on how to adjust their running technique and what exercises they should be doing to reduce the likelihood of injury dashing their running dreams.”

The Body Mechanic have helped thousands of runners return from injury and achieve their running goals. If you are getting ready to Return To running after injury, we recommend you follow this simple structured guide.

To ensure your injury doesn’t return, you also need to implement a good body maintenance routine of stretches and exercises which are appropriate to your specific injury.

We highly recommend this 3 minute morning stretch ritual. Do this simple 3 minute routine everyday for 30 days and I guarantee you will notice a difference in your flexibility.

For those in Sydney, The Body Mechanic runs Strength and Stability Classes every Monday and Wednesday in North Sydney, as well as Running Assessments. Running Assessments are a great way to identify any weaknesses in your form and get a plan to correct them.